High-energy High-protein Diet Research Articles

Reversing malnutrition and low muscle strength with targeted enteral feeding in patients awaiting liver transplant: A randomized controlled trial.

Most patients with decompensated cirrhosis fail to meet their nutrition targets. The impact of nasogastric feeding (NGF) on malnutrition in cirrhosis remains unknown. This study aims to assess the impact of pretransplant NGF on pre-liver transplant and post-liver transplant outcomes. This single-center, prospective randomized controlled trial of 55 patients with severe malnutrition and low handgrip strength (HGS) compared a standard high-energy high-protein diet to diet plus supplemental nocturnal NGF while awaiting transplant. The primary outcome was a change in HGS. The median age was 58.5 years (IQR: 51.1-64), median MELD was 24 (20-28.5), and 32 (58%) patients were male. The median duration of NGF was 63.0 days (34.5-127), following which time the median between-group difference in HGS was 3.6kg (95% CI: 1.7-5.2, p <0.001), an increase of 20% from baseline. Mid-upper-arm circumference, triceps skinfold, and immune function all increased significantly with NGF. Muscle and nutritional parameters continued to improve with increasing duration of feeding. NGF significantly increased daily energy intake between groups by 1285kcal (95% CI: 860-1677) and protein intake by 51g (95% CI: 32-71) (both p <0.001). All NGF patients met >100% of their measured nutritional requirements. Posttransplant clinical outcomes were similar between groups. Targeted enteral feeding before liver transplant improves HGS, anthropometry, and immune function in severely malnourished patients with cirrhosis. These findings provide a strong rationale for early consideration of NGF to reverse malnutrition and improve muscle strength. Appropriately powered studies should explore whether NGF can also impact clinically relevant outcomes including pretransplant and posttransplant mortality.

Productive Performances of Slow-Growing Chicken Breeds and Their Crosses with a Commercial Strain in Conventional and Free-Range Farming Systems.

Local chicken breeds play a vital role in promoting sustainability by preserving genetic diversity, enhancing resilience, and supporting local economies. These breeds are adapted to local climates and conditions, requiring fewer external resources and inputs for their maintenance. By conserving and utilizing local chicken breeds, sustainable farming practices can be incentivized, maintaining ecosystem balance and ensuring food security for future generations. The present study aimed at evaluating the growth performance and slaughter traits of two local Italian chicken breeds (Bionda Piemontese and Robusta Maculata) and their crosses with a medium-growth genotype (Sasso chicken®) reared in conventional and free-range farming systems. The conventional system used a high-energy high-protein diet in a closed barn with controlled temperature, humidity, and lighting, and a stocking density of 33 kg/m2. The free-range system used a low-input diet (low-energy low-protein diet composed of local and GMO-free feed ingredients), uncontrolled environmental conditions, and a stocking density of 21 kg/m2 in a barn with free access to an outdoor area. The birds were slaughtered at 84 days of age in both systems. The crossbred chickens showed the best results for growth performance in both farming systems compared to local breeds. Within genotype, the final live weight of chickens was similar in the two farming systems. In conclusion, slow-growth crossbreeds should be used in alternative farming systems, demonstrating better performance than pure local breeds.

Effect of diets containing different nutrient density on performance and faecal egg count of West African Dwarf rams

A study was conducted to determine the effect of different nutrient densities on performance characteristics and faecal egg count of West African Dwarf (WAD) rams semi-intensively managed. Twenty four yearling lambs between 10-15kg were used for the experiment. The lambs were allotted to two treatment groups containing 12 animals per group. They were released into the paddock containing sown pasture to graze for 6 hours per day. The animals were randomly assigned to treatments containing two levels of protein-energy density: low energy, low protein (LELP) and high energy, high protein (HEHP) in a completely randomized design. Performance characteristics of WAD rams showed that protein and energy density have significant effect (P&lt;0.05) on weight gain, daily weight gain and protein intake. Metabolic weight gain was influenced (P&lt;0.05) positively by the protein and energy density. Animals fed HEHP diets had significantly (P&lt;0.05) higher protein intake (54.66 g) than those fed LELP diets (22.92 g). The slope observed for animals on HEHP diet was lower compared to that of their counterpart on LELP diet. Hence, HEHP diets improved performance of West African Dwarf sheep as well as reducing the gastrointestinal parasite infection due to lower FEC recorded.&#x0D;

Does a High-Energy High-Protein Diet Reduce Unintentional Weight Loss in Residential Aged Care Residents?

Malnutrition and unintentional weight loss are known to occur in residential aged care facilities (RACFs). The use of oral nutritional supplements (ONS) and high-energy high-protein (HEHP) diets are two foodservice strategies that may be implemented in efforts to reduce unintentional weight loss in RACFs. This observational study aimed to determine whether incorporation of a structured high-energy high-protein diet (sHEHP) into the standard menu could reduce unintentional weight loss in RACF residents. RACFs in this study were facilities that provide long-term care to older adult residents. Weight change, body mass index and subjective global assessment scores of participants were measured at baseline and at six months across five RACFs receiving usual care with ONS or a sHEHP diet. Groups were different at baseline, with a high prevalence of severe malnutrition observed in the ONS group. Over the six-month period, there was a small but statistically significant difference in weight change within the groups: −1.64 ± 3.62 kg, ONS group; 0.56 ± 2.76 kg, sHEHP group, P = 0.0004. Both approaches investigated are feasible, however, future research using high-quality methods is needed to determine the most effective approach to deliver best practice nutrition care for residents into the future.

Oxidative status of growing West African dwarf goat kids fed diets containing different nutrient density

Nutritional manipulation is the best option against parasitic infection in ruminants, as it has no residual effect on the animal. Nutrition improves the resilience and resistance of the infected animals and eliminates the resultant clinical anaemia. Twenty-four growing intensively raised West African dwarf (WAD) goats (10.2 + 0.78) were used to assess the effect of incremental levels of protein and energy on the performance characteristics and oxidative status of the WAD goats. The animals were individually housed and allotted to diets containing varying levels of crude protein and energy levels: high-energy high-protein (HH), medium-energy medium-protein (MM) and low-energy low-protein (LL) diets in a completely randomised design. Data were collected for changes in weight gain, haematogical and serum constituents, oxidative stress biomarkers and faecal egg count. Higher levels of energy and protein in the diets increased (P < 0.05) metabolic weight gain (kgBW^0.75) and average daily gain (g/day). Increased levels of crude protein and energy significantly (P < 0.05) increased packed cell volume, haemoglobin concentration and red blood cell count of the goats. Thiol concentration was increased (P < 0.05) with increased level of protein and energy in the diets. The observed reductions in egg per gram of the faeces were similar among the treatment groups. Therefore, increased levels of protein and energy in the diets improve the dry matter intake and daily weight gain with increased erythrocyte count and antioxidant status (through increased thiol concentration) in goats fed MM and HH diets.

Improving effect of dietary soybean phospholipids supplement on hepatic and serum indexes relevant to fatty liver hemorrhagic syndrome in laying hens.

In order to investigate the effect of dietary soybean phospholipid supplement on hepatic and serum indexes relevant to fatty liver hemorrhagic syndrome (FLHS) in layers, 135 300-day-old Hyline Brown layers were randomly divided into three groups (control, pathology and prevention), and each group had 45 layers with three replicates. Birds in the three groups were respectively fed the control diet, high-energy low-protein diet and high-energy high-protein diet affixed with 3% soybean phospholipid instead of maize. Results showed in the 30th day, birds' livers in the pathology group became yellowish, enlarged in size and had hemorrhagic spots, while the prevention and control groups' layers did not have such pathological changes. Contents of triglyceride, total cholesterol, low-density lipoprotein - cholesterol, non-esterified fatty acid and malondialdehyde in serum or liver homogenate in prevention and control groups were remarkably lower than those in the pathology group (P<0.05 or P<0.01), as with the activities of glutamic oxalacetic transaminase and glutamic-pyruvic transaminase (P<0.01); high-density lipoprotein - cholesterol value was strikingly higher than that of the pathology group (P<0.01). It is suggested dietary soybean phospholipids supplement may effectively improve hepatic and blood indexes relevant to FLHS, which provides a new point for preventing FLHS occurrence rate in laying flocks and treating human non-alcohol fatty liver disease.

The Challenge of Appropriate Identification and Treatment of Starvation, Sarcopenia, and Cachexia: A Survey of Australian Dietitians

Malnutrition is an umbrella term that includes starvation, sarcopenia, and cachexia; however, differentiating between these terms is infrequent in clinical practice. Given that the effectiveness of treatment depends on the aetiology of unintentional weight loss, it is important that clinicians are aware of the defining characteristics. The aim of this study was to determine whether Australian dietitians understand and use the terms starvation, sarcopenia, and cachexia and provide targeted treatment strategies accordingly. Members of the Dietitians Association of Australia were surveyed to gain information on practices and attitudes to diagnosis and treatment of adult malnutrition. In addition, three case studies were provided to examine understanding of starvation, sarcopenia, and cachexia. 221 dietitians accessed the survey. 81 respondents (43%) indicated the use of at least one alternate term (starvation, sarcopenia, and/or cachexia). Muscle wasting was the most commonly used diagnostic criterion. High-energy high-protein diet was the most common therapy prescribed. Correct diagnoses for case studies were recorded by 6% of respondents for starvation, 46% for sarcopenia, and 21% for cachexia. There is a need for increased awareness of the existence of starvation, sarcopenia, and cachexia amongst Australian dietitians and research into appropriate methods of identification and treatment for each condition.

Nutrient digestibility and feedlot performance of lambs fed diets varying protein and energy contents

Thirty-six Thalli male growing lambs were used in a completely randomized design with 2 x 2 factorial arrangement of treatments to evaluate the effect of varying levels of energy and protein on nutrient intake, digestibility, weight gain, and gain to feed ratio. Four experimental diets, i.e., low energy-low protein (LE-LP), low energy-high protein (LE-HP), high energy-low protein (HE-LP), and high energy-high protein (HE-HP) were formulated. The low- and high-energy diets contained 2.3 and 2.7 MJ/kg dry matter (DM) with 12% and 14% of crude protein. The lambs were fed ad libitum. Dietary energy and protein levels and their interactions influenced the nutrient intake. Maximum dry matter intake was noted in animals fed LE-HP diet followed by LE-LP, HE-HP, and HE-LP diets. Digestibility of DM and N increased (P < 0.01) and that of neutral detergent fiber decreased (P < 0.01) linearly with increasing levels of dietary energy and protein. Digestibility of N was only affected by protein level and interaction between energy and protein levels. Average daily gain was higher (P < 0.01) in lambs fed HE-HP diet followed by LE-HP, LE-LP, and HE-LP diets. Dietary energy and protein levels and their interaction had significant effect (P < 0.01) on gain to feed ratio.

The effect of short-term nutritional supplementation of ewes with lupin grain ( Lupinus luteus), during the luteal phase of the estrous cycle on the number of ovarian follicles and the concentrations of hormones and glucose in plasma and follicular fluid

An experiment was conducted using 16 cyclic, Welsh Mountain ewes during the luteal phase of the estrous cycle to determine the effect of a 5-day period of feeding a high-energy high-protein diet (lupin grain; 500 g/day) on folliculogenesis and on the plasma concentrations of glucose, insulin, follicle stimulating hormone (FSH) and estradiol-17β, and on the follicular fluid concentrations of glucose, inhibin A, estradiol-17β, androstenedione and progesterone. Average weight did not differ between lupin-fed and control groups during the experiment. There was a trend for the number of small and large follicles to increase in the lupin-fed group. The plasma concentrations of glucose ( P = 0.012) and insulin ( P = 0.007) were higher during the feeding period in lupin-fed ewes. The plasma concentrations of FSH and estradiol-17β were not significantly different. The mean follicular fluid concentration of glucose (small follicles; <3.5 mm) from lupin-fed ewes was elevated ( P = 0.010) and progesterone lowered ( P = 0.034) compared to controls. The follicular fluid concentrations of estradiol-17β, androstenedione and inhibin A were not significantly different. The follicular fluid concentration of estradiol-17β was positively correlated with androstenedione ( r = −0.241; P = 0.001) and inhibin A ( r = 0.734; P ≤ 0.001) and glucose was negatively correlated with inhibin ( r = −0.241; P = 0.01), but not estradiol ( r = 0.075; P = 0.410) or androstenedione ( r = 0.050; P = 0.564). The lupin grain supplement increased the number of follicles as expected, but this increase was not significant. These changes were reflected in follicular fluid where lupin feeding increased the concentration of glucose and decreased the concentration of progesterone in follicles less than 3.5 mm in diameter. These data suggest that the local ovarian actions of nutrients have a role in the mediation of nutritional influences on folliculogenesis.

The regression of unsuckled mammary glands during lactation in sows: the influence of lactation stage, dietary nutrients, and litter size.

During lactation in the sow, mammary glands that are not regularly suckled undergo regression. This study characterizes the regression of unsuckled mammary glands and how that regression is affected by dietary nutrients and litter size. Sixty-nine primiparous sows were fed one of four diets containing combinations of two protein levels (32 or 65 g lysine/d) and two energy levels (12 or 17.5 Mcal ME/d) during lactation. Litter size was adjusted to 10. Sows were killed on d 0, 5, 10, 14, 21, or 28 of lactation. In another experiment, twenty-eight primiparous sows were allotted to have different litter sizes and were killed on d 21 of lactation. The day before slaughter, teat order of each litter was observed. After death, mammary glands were removed and dissected. Skin and extraneous fat pads were removed from the mammary glands and individual glands were separated. Each gland was weighed, cut in half to measure cross-sectional area, and ground for chemical analysis. The amounts of dry tissue, protein, fat, ash, and DNA were measured. Only glands observed to be unsuckled were included in the results. Regression of unsuckled mammary glands occurred rapidly during the first 7 to 10 d of lactation, as indicated by a decline in wet weight, dry weight, protein, fat, DNA, and cross-sectional area. The rate of regression was slowed after the early lactation period. The rate of regression of unsuckled glands was affected by dietary nutrient levels. Dietary energy level affected (P < 0.05) the decline in wet and dry weights, protein, fat and DNA content, and cross-sectional area, whereas dietary protein level affected (P < 0.05) the decline in dry weight and fat content. At d 5 of lactation, the wet weight of unsuckled mammary glands in sows fed the high-energy high-protein diet was 91% greater (P < 0.05) than in sows fed the low-energy low-protein diet. Effects of litter size on size and composition of unsuckled glands were not significant by d 21 of lactation. Unsuckled mammary glands regress rapidly during early lactation, and the rate of regression is affected by dietary nutrient intake.